I went to see my GP after joining NAPS to ask to be referred to by local specialist. He actually laughed in my face and said "they won't help you", you need a hysterectomy, i am 39.Needless to say devastated and humiliated is an under statement.

Hi tallbird, how awful, I’m so sorry to hear that. He sounds like a terrible doctor, and a badly misinformed one. The British Medical Journal published a clinical review of premenstrual disorders in 2011 and I’ve copied and pasted the list of treatments from it below. As you can see, surgery is way down the bottom, as a very last resort. Many women don’t even need to go further than the first section of lifestyle changes. Personally I’m in the second section, trying antidepressants (Fluoxetine), and they’re working for me. I would go back to your surgery and ask to see a different doctor – and I would also consider making a formal complaint about the poor treatment you received from this doctor.

TreatmentsThe following treatments are supported by evidence based studies and expert consensus reports. The doses that have shown efficacy in randomised trials are given in parenthesis.

AnxiolyticsAlprazolam (0.25-4.0 mg two to three times a day)Buspirone (10-60 mg/day)

Hormone based treatments

Progesterone and progestogens: not recommendedNorethisteroneMedroxyprogesterone acetateLevonorgestrel

Ovulation suppression

Oral contraceptionDrospirenone and lower doses of ethinylestradiol

Gonadotrophin releasing hormone agonistGoserelin (one off injection of 3.6 mg for one month or 10.8 mg for three months), with or without add back with gonadotrophin releasing hormone treatment (tibolone 2.5 mg/day)

Gonadotrophin inhibitorDanazol (200-400 mg/day)

EstradiolTransdermal patches (100 mg; increase to 200 mg if ovulation is not suppressed)Subcutaneous implants (50 mg; increase to 75 mg or 100 mg if ovulation is not suppressed)

SurgeryBilateral oophorectomy and hysterectomy

_________________I'm 34 and have had severe PMS for 5 years. Trying to manage it with medication (currently 4mg Prozac) and lifestyle changes (exercise, diet, stress management).

Please do try the complementary therapies first. I have had great success on Agnus Castus (but it has to be 20mg standardised extract equivalent to 200mg whole fruit). There is plenty of research evidence out there (you can find some of it on my blog http://julietocallaghan.wordpress.com/ search the category Agnus Castus). I have been reading about red clover and there is some research evidence for this as well, although I have not tried it.

When Agnus Castus was compared to prozac it worked equally as well without the side effects.

Stopping ovulation either chemically or surgically should be the last resort.

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